Table 1.
Clinical characteristics and resource utilization for all patients stratified by number of complications.
| Variables | Overall cohort (n=50314) | No Postoperative Complications (n=20748) | One Postoperative Complication (n=13200) | Two Postoperative Complications (n=6075) | Three and more Postoperative Complications (n=10291) |
|---|---|---|---|---|---|
| Age >=65, n (%) | 16367 (32.5) | 5791 (27.9) | 4300 (32.6) * | 2237 (36.8) * | 4039 (39.3) * |
| Female sex, n (%) | 24668 (49.0) | 11275 (54.3) | 6396 (48.45) * | 2721 (44.8) * | 4276 (41.6) * |
| African-American ethnicity, n (%) | 6182 (12.3) | 2423 (11.68) | 1706 (13.0)* | 758 (12.5) | 1295 (12.6) |
| Primary Insurance, n (%) | |||||
| Medicare | 19467 (38.7) | 6810 (32.8) | 5360 (40.6) * | 2690 (44.3) * | 4607 (44.8) * |
| Medicaid | 6517 (13.0) | 2680 (12.9) | 1551 (11.8) * | 733 (12.1) | 1553 (15.1) * |
| Private | 20591 (40.9) | 9400 (45.3) | 5367 (40.7) * | 2264 (37.3) * | 3560 (34.6) * |
| No insurance | 3739 (7.4) | 1858 (9.0) | 922 (7.0)* | 388 (6.4) * | 571 (5.6)* |
| Weekend admission, n (%) | 6881 (13.7) | 2105 (10.2) | 1713 (13.0) * | 957 (15.8) * | 2106 (20.5) * |
| Emergency admission, n (%) | 22818 (45.4) | 6995 (33.7) | 5866 (44.4) * | 3128 (51.5) * | 6829 (66.4) * |
| Charlson-Deyo Comorbidity Score, n (%) | |||||
| 0 | 18490 (36.8) | 9996 (48.2) | 4692 (35.6) * | 1630 (26.8) * | 2172 (21.1) * |
| 1-2 | 19398 (38.5) | 7166 (34.5) | 4890 (37.1) * | 2554 (42.0) * | 4788 (46.5) * |
| >=3 | 12426 (24.7) | 3586 (17.3) * | 3618 (27.4) * | 1891 (31.1) * | 3331 (32.4) * |
| Type of Procedure, n (%) | |||||
| Cardiothoracic Surgery | 6755 (13.4) | 912 (4.4) | 1297 (9.8) * | 1282 (21.1) * | 3264 (31.7) * |
| Neurologic Surgery | 8385 (16.7) | 3512 (16.9) | 1985 (15.0) * | 899 (14.8) * | 1989 (19.3) * |
| Non-Cardiac General Surgery | 10741 (21.3) | 4571 (22.0) | 3180 (24.1) * | 1349 (22.2) | 1641 (16.0) * |
| Specialty Operations† | 15229 (30.3) | 9276 (44.7) | 3789 (28.7) * | 1095 (18.0) * | 1069 (10.4) * |
| Other Operations ‡ | 9204 (18.3) | 2477 (11.9) | 2949 (22.3) * | 1450 (23.9) * | 2328 (22.6) * |
| Postoperative Complications, n (%) | |||||
| Acute kidney Injury | 19644 (39.0) | NA | 6417 (48.6) * | 3767 (62.0) * | 9460 (91.9) * |
| ICU admission for longer than 48 hours | 16,244 (32.3) | NA | 2743 (20.8) * | 3674 (60.5) * | 9827 (95.5) * |
| Cardiovascular complications or need for vasopressors | 11786 (23.4) | NA | 1618 (12.3) * | 2215 (36.5) * | 7953 (77.3) * |
| Mechanical ventilation for greater than 48 hours | 6931 (13.8) | NA | 35 (0.5) * | 319 (4.6) * | 6577 (94.9) * |
| Mechanical wound complications and surgical infections | 5944 (11.8) | NA | 1589 (12.0) * | 1387 (22.8) * | 2968 (28.8) * |
| Neurologic and delirium complications | 4037 (8.0) | NA | 796 (6.0) * | 750 (12.4) * | 2491 (24.2) * |
| Severe sepsis | 2302 (4.6) | NA | 2 (0.02) | 38 (0.63) * | 2262 (22.0) * |
| Resource utilization | |||||
| Days in hospital, Median (25th, 75th) | 7 (4, 12) | 4 (3,6) | 6 (4,10) * | 9 (6,14) * | 20 (12, 35) * |
| Hospital cost (1000$), Median (25th, 75th) | 19 (12, 38) | 13 (9,18) | 17 (12, 28) * | 28 (19, 42) * | 70 (42, 118) * |
| ICU admission, n (%) | 26433 (52.5) | 4454 (21.5) | 6637 (50.3) * | 5130 (84.4) * | 10212 (99.2) * |
| Days in ICU, Median (25th, 75th) § | 4 (2, 8) | 1 (1,2) | 2 (1,4) * | 4 (2,7) * | 10 (5,19) * |
| 12873 (25.6) | 879 (4.2) | 1640 (12.4) * | 1909 (31.4) * | 8445 (82.1) * | |
| Mechanical ventilation, n (%) | |||||
| Days on mechanic ventilation, Median (25th, 75th) § | 3 (2, 11) | 1 (1,2) | 2 (1,2) | 2 (1,2) | 7 (3,18) * |
| Discharge, n (%) | |||||
| Discharge to home | 37220 (76.9) | 17724 (85.4) | 10613 (80.4) * | 4493 (74.0) * | 4390 (42.7) * |
| Discharge to nursing home | 3971 (8.2) | 929 (4.5) | 888 (6.7) * | 522 (8.6) * | 1632 (15.9) * |
| Discharge to other acute care facility/hospital | 3631 (7.5) | 993 (4.8) | 898(6.8) * | 491 (8.1) * | 1249 (12.1) * |
| Discharge to rehab facility | 3594 (7.4) | 1094 (5.3) | 750 (5.7) | 429 (7.1) * | 1321 (12.8) * |
*
p-value <0.05 for comparison with respect to no postoperative complications group using Bonferroni adjustment
†
Specialty operations include orthopedic, gynecologic, head and neck, urologic and plastic surgery procedures.
‡
Other operations include trauma, burn and transplant procedures.
§
Reported only for patients who were admitted to ICU and for patients who required mechanical ventilation, respectively.